Pressure Injury Morbidity and Risk Factors in Elderly Sepsis Patients: A Retrospective Analysis of a Nationwide Inpatient Sample Database

Abstract

Objective: This study evaluated the prevalence and risk factors associated with pressure injuries (PIs) among elderly sepsis patients by analyzing a comprehensive national inpatient dataset. Methods: A retrospective analysis was conducted using data from the National Inpatient Sample (NIS) database covering the years 2010 to 2019. Elderly patients aged 65 years and older with a diagnosis of sepsis and complete medical records were included. Patients were categorized into two groups based on the presence or absence of pressure injuries. Demographic variables, comorbidities, and complications were assessed using both univariate and multivariate logistic regression analyses to identify risk factors related to pressure injuries. Results: Our analysis identified 1,687,410 sepsis patients aged 65 and above, with 193,645 (10.3%) developing pressure injuries. The morbidity rate for pressure injuries exhibited a gradual decline from 12.7% in 2010 to 9.2% in 2019. Patients with sepsis who developed pressure injuries had significantly longer hospital stays, higher hospital costs, and increased in-hospital mortality (all p < 0.001). Among the comorbid conditions identified, diabetes, anemia, paralysis, neurological disorders, peripheral vascular disease, electrolyte imbalances, weight loss, and incontinence were associated with higher rates of pressure injuries. Patients with PIs were also more likely to experience complications such as deep vein thrombosis, septic shock, delirium, respiratory failure, and malnutrition. Conclusion: Despite significant global efforts aimed at reducing pressure injuries, the morbidity rate among elderly sepsis patients remains notably high at 9.2%. Therefore, it is essential to develop targeted, evidence-based interventions focused on the identified risk factors to effectively reduce the incidence of pressure injuries and improve patient outcomes.